Please return this portion with your dues payable to
THACS P.O. Box 2095, Houma, LA 70361 Phone: 985-851-0154
Terrebonne Historical & Cultural Society
MEMBERSHIP
     
____ Individual $20 Organization: ____ Organization $35
____ Family $35
      (best value for 2 people)		    
____ Contributing $50 Business: ____ Corporate $100
____ Donor $100   ____ Supporting $250
____ Supporting   ____ Benefactor $500
Total Enclosed $_______________  
     
Is this a   ____ New Membership?   ____ Renewal?   _____ Gift Membership?
     
Member Name(s):  _________________________________________________
Mailing Address:  __________________________________________________
Gift from (please list name & address):  ________________________________


Thank you for your support.